My Experience So Far...

Hi guys,

I'm probably hear to just pen my story as much as anything else. I've read over these forums countless times over the past 10 years, particularly over these past nine months.

Whilst my tinnitus is not debilitatingly loud, as many of you unfortunately have to endure, I am puttng it all here in the hope that someoe may benefit from it, or to know that my story lines up closely with that of others.

I have had constant tinnitus since about 2002, but it had never really bothered me. It was something I could hear if I competely blocked my ears, or if I listened out for it late on a quiet night. It didn't come as too much of a surprise that I had tinnitus to a small extent, I had been to my fair share of raves, clubs, parties and everything that goes with it, listened to headphones and I have been around fiearms (always with the use of hearing protection) my entire life.

Aout 9 months ago in early Octoer 2014 I had one incident on a hunting trip where I fired 3 rounds from a .243 calibre rifle before realising that I did not have my haring protecion in. This is rare for me, as I am usually very pedantic when it comes to protecting my ears. That night I dealt with the usual slight increase in tinnitus that one would expect after such an exposure. In the days that followed I did not recall noticing any level of tinnitus that I would consider out of the ordinary and thought little more of it.

Approximately two weeks later I was sitting at my desk in the office at work, when I noticed that my tinnitus was exceptionally loud, where usually it is inaudible in the ambience of the fairly quiet office. It was actually at the point of being extremely distracting and became an immediate concern to me.

I began referring to "Dr Google" frantically as I am sure we all do, as I had hoped that it wasn't the recent noise exposure that had caused this, and soon found myself reading about conditions such as Eustachian Tube Dysfunction. It was at this point that I realised that I couldn't perform the Valsalva manouver at all, my tubes were completely blocked up. A few weeks prior I had returned from a work trip to the Philippines and while there I had a lingering virus/flu that lasted for a couple of weeks and had spend a lot of time flying during the tail end of the virus. Another possible cause I suspected?

After dealing with this for a number of days, I made the trip to my GP who prescribed me a short course of oral Prednisolone and Stemetil. After a couple of days this did provide some relief, reducing the tinnitus by close to 50%, and whilst it wasn't 'back to normal' it was enough that I was beginning to feel a real sense of returning to normality emotionally, and a feeling that it was a hurdle I could now put behind me, having been through the psychological torment that we can all relate to following the sudden onset of tinnitus. I could also finally Valsalva, albeit only with a tilting of my head to each side to help 'pop' the ear on the opposite side.

Unfortunately however, once I ceased the Prednisolone the tinnitus came back within 12 hours or so, with a vengeance. It was unbearably loud.

I returned to my GP who gave me a referral on to an ENT specialist. The ENT's first observation was that I have a severe nasal septum deviation and so cramped was my nasal passage due to the deviation and turbinates that she couldn't fit the camera into my right nostril to examine my Eustachian tubes (ET). She advised that septoplasty and turbinate reduction may resolve the problem, but even if it does not, I suffer from a number of other problems as a result of my nasal issues that in themself would warrant the surgery.

I was referred to an audiologist who performed a hearing and a tympanometry test which revealed that my ear pressure was 'normal' (A) suggesting no eustachian tube dysfunction. This was incredibly frustrating as I knew that my ET's were in a bit of a mess. She also stated that I had some high frequency hearing loss, particularly in my right ear which she said was consistent with noise induced hearing loss. My hearing loss isn't bad, but it is enough that at a noisy restaurant or bar I may have some minor difficulty hearing the person on the far side of the counter.

Soon after I recommenced treatment with some remaining Prednisolone and found that soon after I again experienced noticable relief, with a reduction in tinnitus and increased ease in Valsalva which returned to the way it was again following the cessation of the treatment.

The ENT soon after had me try Nasonex Allergy spray, which has worked to a small extent with increased ease in breathing through my nose and a slight reduction in the tinnitus level. I was sent for a blood test to reveal if I had any allergies, all tests came back negative.

In addition to the tinnitus and blocked ET and tinnitus, I have also had constant crackling and popping and 'squelching' noises when tilting my head or when swallowing. When I form a pressure bubble of air inside my cheeks there is a crunching noise as my ET's expand which is audible to other people if the room is quiet. My ENT was perplexed when she heard this, she couldn't believe it and her response was something along the lines of "that shouldn't happen". She has said that there may be a viral cause and has sent me away for another blood test to test for a large number of illnesses including Hep, HIV and Toxoplasmosis among many others to rule each of these out.

During this consultation she also discussed with me my audiometry results, and much of what she said seemed to contradict the words of the audiologist. For example, she said that my hearing loss is only in one frequency and only on the right side, although she said there was also some very minor loss on the left. She said that noise induced hearing loss would generally be across more than one frequency and across both ears, not just one. If anything, my left ear should theoretically be worse as I am a right handed shooter, however my right ear is worse. She said this suggested a viral cause rather than a noise induced or genetic one. I have also since had an MRI which came back normal and ruled out any accoustic neuroma or other abnormality.

Despite all of this, the underlying message in each of my consultations has been that this may not be curable, and I may ned to learn to deal with it or look at anxiety medications should they be required.

I am not really sure what to think about it all, I just hope that in time that this does go away. The crackling, popping and associated problems are bad enough on their own but it's the tinnitus that can really make me cringe at times. I guess only time will tell.

Hopefully when I do have the nasal surgery done it does indeed resolve the problems. I have read reports of people having septoplasty and it appears to be hit or miss as far as curing tinnitus is concerned. It would seem logical that any issues with your nose may prevent drainage and lead to an increased blocking of sinuses or ET's.

Please let me know if you too have shared in a similar experience or have any further suggestions or recommendations for me. If anything, hopefully this is a help in some way shape or form to others, I will keep the thread updated with any developments as they arise.

Kind regards,

Simon

 

G'day Simon.

Haven't come across too many shooters in Australia, although they obviously exist!

Unfortunately I can't add too much to your own experiences, though I certainly hope things get better for you. I have tonnes of nasal issues too, so I'll be interested to see whether your surgery makes any discernible difference.

Best of luck to you!

 

Feelings of blocked ears or ear pressure with normal tympanometry results is quite common in tinnitus sufferers. It seems to be a common symptom of hearing damage among us.

Do you feel any pain at all?

 

I get the odd pressure pain feeling but it usually passes after a few seconds.

 

Thanks!


There are quite a few shooters down here, 800,000 of them actually. I take it you're a shooter also?

 

No, I'm not a shooter at all. Hence my surprise!

 

Hi Simon,
This post is hopefully something that may help yourself and other folks out there. I've found something helpful!!!

I had sudden onset of hearing problems in my L ear after a head injury and skull fracture likely damaging the cochlear as well as my auditory cortex.

The symptoms I have are L sided hearing loss particularly high frequency hearing loss, tinnitus but the worst symptoms by far are the symptoms of Tonic Tensor Tympani Syndrome/Acoustic Shock Disorder (TTTS /ASD). Here is some info by a fellow Aussie world expert in the field. http://www.dineenwestcottmoore.com.au/uploads/ASD_TTTS_guide_medical_professionals.pdf

The worst symptoms I have are the dull constant L sided headache and the feeling of fullness or numbness on that side of my head. These symptoms get worse when the tinnitus gets louder. I wonder if the severe symptoms people get with their tinnitus are actually due to TTTS. I frequently also experience the crackling sounds which I believe are due to the Eustachian tube opening and closing.

TTTS/ASD was actually described in returned serviceman during WW1 or 2 and is commonly seen in soldiers returning from the middle east. The common cause being exposure to loud sounds as you experienced.

My theory is that whatever the cause of hearing loss it often results in loss of higher frequencies as this is the most sensitive to damage. This results in tinnitus and TTTS. I believe the TTTS is an attempt by the brain to reflexively boost the high frequency vibrations by increasing tension on the tympanic membrane. This is purely my theory and based on no evidence at all but makes sense from my understanding of physics. A floppy TM wont detect those high frequencies as well.

I also was tried on steroids which I don't think did much.

After a second hearing test showing moderate high range hearing loss the audiologist suggested trialling a hearing aid. My first reaction was shock horror, I need one of those? I put it on and immediately the headache, the fullness melted away. The tinnitus settled. I listened to some meditation music and it was bliss. I was hearing sounds with that ear I hadn't heard in months. I tested it in various environments turning it off and on and the difference was profound.

The price was off putting and I knew it was likely going to get broken or lost. I did some reading and I discovered a personal sound amplification device called soundworldsolutions CS50. It sounded good so I bought one. It's fantastic. You can easily customise it after bluetoothing to your phone. It can easily be adjusted for different situations. You can play music through it from your phone and phone calls can be heard through it.

I did a side by side comparison with a Phonak V90 using an online hearing test which is great to check your hearing with. http://newt.phys.unsw.edu.au/jw/hearing.html

It actually performed better at restoring the high frequency loss.

It is much more conspicuous than a hearing aid and looks like a Bluetooth headset device but I don't care about the aesthetics. It cost $379 from ALDS Australia vs $6020 for the Phonak. The Phonak also required another $216 for a Bluetooth device for you to adjust it.

It is not a "hearing aid" because they are medical devices and have more stringent FDA/TGA approval procedures but that's what makes them so much cheaper.

My suggestion to anyone who suffers any of these symptoms is to test your own hearing using the link I posted. Block each ear and use headphones as laptop speakers aren't great for testing. You wont have a reference if both ears are bad so you might need to compare with a young healthy child if you. OR get a free hearing test and when/if they suggest you might need a hearing aid get a free 1wk trial. If it helps your know your options.

Best wishes,
Andre

 

Thanks Andre, and some interesting info there. I am not sure if my issues are the same as yours as I haven't sustained any head trauma that may cause it.

 

No worries. The causes of tinnitus are varied but in most cases it is due to some degree of hearing loss as shown in your audiometry. It is not unusual to start experiencing tinnitus more severely a period of time after the insult as it is the brains adaptation to the loss of audio output from the cochlear that causes the tinnitus. I strongly suspect it was the loud gunshots that caused the damage as this is a common cause.

Things in medicine are more grey than black and white which can be frustrating but unfortunately the reality. (I'm a doctor btw). The experience you had with your ENT consultations is not surprising. These things can be difficult to figure out and ENT specialists are more surgeons than physicians. I had 2 ENT consultants involved who were both great people but sort of lost interest when there was nothing obvious they could do.

There was a period where I was in a bad way. I was recovering from the brain injury well but the hearing issues were driving me crazy and I was getting pretty depressed about it. I still need some background meditation music on to sleep which is not great for my wife. I was wide awake last night at 2am trying to get to sleep. Unfortunately I can't wear my hearing aid to bed.

However, this turn around for me was something unexpected and I feel so much better now.

 

Is it normal to experience blocked Eustachian tubes as a result of hearing damage? I was given some hope by the prednisolone as I didn't think it would be of any help if my tinnitus was noise induced, but for the time that I was on the course it was quite helpful.

I did also find it odd that the audiologist said that it was noise induced hearing loss, but the ENT specialist said it didn't look that way as it was only in one ear and was only at one frequency whereas noise induced loss would occur at a range of frequencies.

 

I believe in some cases it is a physical ailment and the Doctors just can't find the solution and get frustrated and give up. There is something going on in the somatic nerves of Tinnitus sufferers . I also feel fullness Eustachian tube blockage and crackling in my ears my T could be a mirror image of yours besides the noise damage part of your story . My t happened after ear wax removal then kind of seemed like a sinus Eustachian tube problem. I went to 3 ENT doctors ER 2 times a primary care doctor 10 times and a psychiatrist that got me some sleep meds now I don't take anything . After 10 months I have really habituated to my T nicely but not completely. It just does not bug me now and mostly low volume .I still don't know if it is physical or mental. I do the netti pot flush it seems to help . I have been using hydrogen peroxide . The doctors say not to use it in ears but I do and it helps a lot. So who the H,,, knows what this really is . If anybody knows the answer they would be very rich. I just live with mine now and try things to make it go away maybe one day I will make it go away completely . I don't believe T is because of hearing loss but hearing loss is symptom . It is nerve damage that causes T which in turn may but not always cause hearing loss. Uncle Vikin

 

Yours culd indeed be ver similar to mine. Unfortunately I really do not know what the cause of mine is, I just know that my ears ring and my tubes are blocked + crack & pop all the time. I have a number of possible causes and have conflicting views from ENT's and audiologists. The one thing they do agree on seems to be that it is something that I will just need to deal with.

The crackling and popping in my ears happens whenever I tilt my head sideways, swallow or especiallywhen I yawn. I usually get a number of consecutive cracks and pops and occasionally squeeking noises. Performing a valsalva maneuver is difficult and uually requires me to tily my head each way - there's definitely problems there but my tympanometry test was normal :S

The only real hope I feel I have, hving been this way for 9 months now, is that surgery to correct my nose will resolve these issues.

I have read many reports tha are encouraging, and just as many if not more that are not.

 

It is not common to experience blocked Eustachian tubes after hearing loss. Eustachian tube dysfunction can lead to hearing loss by recurrent middle ear infections but this is usually a chronic issue. Eustachian tube function is important to hearing since equal pressure on both sides of the TM allows its vibration.

The crackling sounds are likely due to your ET popping open which suggests that they aren't completely blocked. Viral infections can temporarily lead to ET blockage but should settle down after a few weeks.

Be aware that ENTs don't have a lot of faith in the tympanometry part of audiometry which is why they may contradict each other. They are pretty reliable in detecting conductive vs sensorineural hearing loss and from the sounds of it you have sensorineural? If that is the case then it seems doubtful that Eustachian tube dysfunction is the cause of your hearing loss.

Of course there may be a number of factors contributing.

I don't think it's true that loss in a particular frequency rules out noise induced hearing loss. Sudden loud noises can produce reversible as well as irreversible hair cell damage. Other injuries such as recurrent loud music as well as normal ageing may result in loss of hair cells corresponding to a particular frequency. I am very deaf at 12kHz, not so bad at 8kHz but worse again at 6kHz. It just depends which group of hair cells are lost.

Uncle Vikin, with respect, it's pretty well accepted that tinnitus is usually the result of hearing loss whether it's due to wax, middle ear problems, inner ear problems or vestibulocochlear nerve problems. It is the loss of auditory stimulus to the auditory cortex which results in tinnitus. Yes, it is sort of a nerve being that it is the brain but it's not the brain which is damaged.

 

Yes, my hearing loss is sensorineural.

Does anyone have any knowledge on nasal issues and ETD/tinnitus? Can septoplasty and turbinate reduction assist (potentially)?

 

Then everybody that is deaf has tinnitus come on and also some people have tinnitus with perfect hearing no freq. lost. I am talking 17 year olds . No they don't know what they are talking about don't believe everything you hear even from doctors or researchers or me . The fact is nobody knows what is going on. But my belief is it is nerve damage either going to the brain back from the brain or the brain itself or in the cochlear or somewhere in the nervous system . Now you go find it. That is the problem it is too massive for the doctors to find. Even great emotional stress can damage neurons or nerves. It is like finding a needle in a haystack. But I also think tinnitus in some cases is just a plain ole ear condition that doctors don't treat correctly, like ear wax, infections ect. in the US, doctors are just giving up the profession because of the current healthcare system we have, so most just don't care anymore and don't make the extra effort to treat their patients, sad but true.

 

when an audio cord is bad or has a short the sound either hisses has static squeals or goes silent. So the short causes the noise and when it shorts out completely it is silent that is deafness. As long as there is a hiss or tone whatever it is still trying to make the connection to fix tinnitus find the short repair it or reroute the signal.

 

I was thinking of splashing out on a pair of the Phonaks. Maybe I should go down this route instead.

 

Update - I changed my GP and went and saw them recently to get a referral for another ENT surgeon that works on the public health system and the new GP has diagnosed me as having TMJ. I do grind my teeth badly and catch myself clenching my jaw a lot during the day. I also find my jaw gets worn out very quickly when I chew these days.

Might explain why prednisolone helps my tinnitus as it would help ease the inflammation.

I was referred to a physio as well and had my first session the other day, just learnt a few exercises to help loosen my jaw, but will likely be months before it starts to make a difference.

I'll also raise it with my dentist when I visit next.

At least I feel a little closer to finding a cause.